| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERV USA INC (CA) | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 2.43% |
| CRYSTAL & COMPANY3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 21250 HAWTHORNE BLVDE STE 600 TORRANCE, CA 90503 | HARTFORD LIFE AND ACCIDENT | $11K | — | $11K | 8.43% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INS CTR | 123 MISSION ST 26TH FLOOR SAN FRANCISCO, CA 94105 | HARTFORD LIFE AND ACCIDENT | — | $694 | $694 | 0.52% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA, | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $701 | — | $701 | 2.50% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 477 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 482 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 797 | $178K |
| Vision | VISION SERVICE PLAN | 354 | $28K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 477 | $133K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 477 | $133K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 477 | $133K |
| Other | HARTFORD LIFE AND ACCIDENT | 477 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 797 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.